The Health Reform Law’s Medicaid Expansion: A Guide to the Supreme Court Arguments

One significant element of the pending U.S. Supreme Court case challenging the Affordable Care Act is the constitutionality of the law’s Medicaid expansion. This provision of the law requires states that choose to participate in the Medicaid program to cover nearly all adults under age 65 with household incomes at or below 133% of the federal poverty level as of January 2014. A ruling on the Medicaid expansion could have far-reaching impacts on the present and future contours of the Medicaid program, the people it is scheduled to serve, and Congress’s power to attach conditions to the federal funds it provides to states.

This policy brief examines the Medicaid expansion, the legal and policy arguments related to it in the pending Supreme Court case, and the potential ramifications of the Court’s decision. A separate brief also examines other aspects of the case.